EXAM 1 Vaccine Strategies

Question 1

why are vaccines important?

Answer 1

missed opportunities

• over 80,000 mortalities per year in the US from vaccine preventable diseases
• 2/3 saw a physician in the previous year but were not vaccinated
• 50,000/yr from pneumonia and influenza
  
  • 8th leading cause of death in the US

Question 2

list the live attenuated vaccines

Answer 2

• herpes zoster
• varicella
• live attenuated influenza
• measles, mumps, rubella
• oral typhoid capsules
• rotavirus
• yellow fever
• oral cholera

Question 3

what is immunization?

Answer 3

the process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine

Question 4

what are vaccines?

Answer 4

stimulate the body’s own immune system to protect the person against subsequent infection or disease

Question 5

what is a live attenuated vaccine?

Answer 5

• made from weakened viruses or bacteria
• must replicate to work
  
  • replication mimics natural infection
  • stimulates immune response

Question 6

what are inactivated vaccines?

Answer 6

• made from various fractions of viruses or bacteria
  
  • subvirions, subunits, polysaccharides, toxoids, recombinant antigens
• do not replicate because they are killed

Question 7

list the inactivated vaccines

Answer 7

• diptheria, tetanus, pertussis
• haemophilus influenzae B
• hepatitis A
• hepatitis B
• human papillomavirus
• inactivated poliovirus
• meningococcol
• pneumococcol
• rabies
• inactivated influenza
• typhoid injection

Question 8

compare live vs. inactivated vaccines

Answer 8

• storage - live vaccines in freezer
• duration of protection - live usually has a longer duration of protection
• adverse effects
• contraindications/precautions - live have more restrictions for use
• usually, live > inactivated

Question 9

what is ACIP?

Answer 9

• advisory committee on immunization practices
• public health and medical experts
• branch of the CDC that makes recommendations in the US on how to use vaccines to protect against disease
• come up with vaccine schedules
• *always follow ACIP recommendations

Question 10

describe vaccines for healthcare providers as a form of practice management

Answer 10

• develop policy for your practice to ensure everyone is appropriately vaccinated as a work requirement
• which vaccines?
  
  • flu, Tdap, hep B, MMR, varicella

Question 11

what is a VIS?

Answer 11

• vaccine information statement
• describes the vaccine and what it protects against
• the patient must be offered VIS with every immunization

Question 12

what are screening questions that should be asked before administering vaccines of any type?

Answer 12

• severe allergy to previous vaccine or components
• current moderate/severe illness with or without fever

Question 13

what are screening questions specific to live vaccines?

Answer 13

• severe immunodeficiency
• pregnant

Question 14

what information should be included on immunization records?

Answer 14

• patient name
• vaccination date
• name, address, title of practitioner giving vaccine
• name of vaccine, manufacturer, lot, NDC, expiration
• signed consent forms

Question 15

what is USIIS?

Answer 15

• utah statewide immunization information system
• utah’s immunization registry
  
  • health care providers, schools, and public programs

Question 16

what are the benefits of reporting immunizations?

Answer 16

• safety
• identification of needed vaccines
• allows for shared records
• practice-site reports

Question 17

describe anaphylaxis symptoms

Answer 17

• sudden or gradual onset of generalized itching
• erythema
• urticaria (hives)
• angioedema (swelling)
• severe bronchospasm
• shortness of breath
• abdominal cramping
• shock
• cardiovascular collapse

Question 18

describe administration technique

Answer 18

• IM vs SC
  
  • no aspiration needed prior to injection
• diluents
• shaking vaccines
• storage

Question 19

describe the transmission of influenza

Answer 19

• respiratory, can spread 6’ away
• incubation 1-2 days, asymptomatic
• virus continues to shed 5-10 days after symptoms begin
• 5-20% of US population get the flu each year

Question 20

what are the signs/symptoms of influenza?

Answer 20

• fever, chills, cough, sore throat, fatigue, muscle or body aches, headache, runny nose, some may have nausea/vomiting
• 50% have classic symptoms, 20% may have no symptoms at all

Question 21

describe complications from influenza

Answer 21

• bacterial pneumonia, sinus or ear infections
• dehydration
• worsening of chronic conditions: asthma, heart failure, diabetes
• hospitalizations (200,000/yr) and death

Question 22

starting in 2010, ACIP recommended all people of what age should get the annual flu vaccine?

Answer 22

greater than or equal to 6 months of age

Question 23

what is VAERS?

Answer 23

• vaccine adverse event reporting system
• any adverse reactions are reported to VAERS